Premenopausal serum androgens and breast cancer risk: a nested case-control study.

ABSTRACT: INTRODUCTION: Prospective epidemiologic studies have consistently shown that levels of circulating androgens in postmenopausal women are positively associated with breast cancer risk. However, data in premenopausal women are limited. METHODS: A case-control study nested within the New York University Women's Health Study was conducted. A total of 356 cases (276 invasive and 80 in situ) and 683 individually-matched controls were included. Matching variables included age and date, phase, and day of menstrual cycle at blood donation. Testosterone, androstenedione, dehydroandrosterone sulfate (DHEAS) and sex hormone-binding globulin (SHBG) were measured using direct immunoassays. Free testosterone was calculated. RESULTS: Premenopausal serum testosterone and free testosterone concentrations were positively associated with breast cancer risk. In models adjusted for known risk factors of breast cancer, the odds ratios for increasing quintiles of testosterone were 1.0 (reference), 1.5 (95% confidence interval (CI), 0.9 to 2.3), 1.2 (95% CI, 0.7 to 1.9), 1.4 (95% CI, 0.9 to 2.3) and 1.8 (95% CI, 1.1 to 2.9; Ptrend = 0.04), and for free testosterone were 1.0 (reference), 1.2 (95% CI, 0.7 to 1.8), 1.5 (95% CI, 0.9 to 2.3), 1.5 (95% CI, 0.9 to 2.3), and 1.8 (95% CI, 1.1 to 2.8, Ptrend = 0.01). A marginally significant positive association was observed with androstenedione (P = 0.07), but no association with DHEAS or SHBG. Results were consistent in analyses stratified by tumor type (invasive, in situ), estrogen receptor status, age at blood donation, and menopausal status at diagnosis. Intra-class correlation coefficients for samples collected from 0.8 to 5.3 years apart (median 2 years) in 138 cases and 268 controls were greater than 0.7 for all biomarkers except for androstenedione (0.57 in controls). CONCLUSIONS: Premenopausal concentrations of testosterone and free testosterone are associated with breast cancer risk. Testosterone and free testosterone measurements are also highly reliable (that is, a single measurement is reflective of a woman's average level over time). Results from other prospective studies are consistent with our results. The impact of including testosterone or free testosterone in breast cancer risk prediction models for women between the ages of 40 and 50 years should be assessed. Improving risk prediction models for this age group could help decision making regarding both screening and chemoprevention of breast cancer.

Evaluation d'un Espace de Prévention dans le cadre du Festival de Jazz de Montreux 2001: la Scène Bleue

L'initiative Scène Bleue (SB) se veut un espace, lieu de rencontre de jeunes adolescents âgés de 10 à 18 ans, dans le cadre de l'édition 2001 du Festival de Jazz de Montreux. Il s'agit de proposer une série d'animations permettant de faire la fête sans consommation de substances (légales et/ou illégales). Ce document fait l'historique du projet et de l'évaluation conduite par l'IUMSP. Cette évaluation comprend trois volets, correspondant à des temps différents : 1. Avant - documenter la perception des objectifs et les attentes des jeunes et des animateurs, avant le démarrage du projet SB. 2. Pendant - analyser la réalisation du projet in situ et recueillir informations et réactions auprès de la clientèle de la SB. 3. Après - examiner l'évolution des perceptions des différents acteurs, après le festival. Les résultats peuvent être résumés comme suit : la SB a rencontré un vif succès. La démonstration a été faite que le public concerné pouvait être attiré par un lieu avec des interdits relatifs à la consommation de substances : ainsi l'objectif de prévention primaire ciblant des jeunes âgés de 13 ans en moyenne a été atteint. Les visiteurs plus âgés, moins impliqués, ont malgré tout pu réaliser que faire la fête sans alcool ni drogues était possible. Le projet peut à l'avenir être consolidé en définissant des objectifs et des stratégies de prévention explicites. La participation des jeunes à cette entreprise collective partagée avec les animateurs et les reponsables peut être sollicitée davantage, notamment pour ce qui est de l'organisation et des choix concrets relatifs aux diverses animations. [Résumé]

Interrelation among Economic Growth, Income Inequality, and Fiscal Performance: Evidence from Anglo-Saxon Countries

The interrelation among economic growth, income inequality, and fiscal performance is very complex. The paper provides the analysis of the interrelations among these variables jointly by the structural VAR methodology, examining also transmission channels among them. This approach allows exploring dynamic interactions among them and feedback effects on each other. The empirical analysis is implemented for the Anglo-Saxon countries, the UK, the USA, and Canada. We find that income inequality has negative effect on economic growth in the case of the UK. The effect is positive in the cases of the USA and Canada. The increase in income inequality worsens fiscal performance for all the countries

El Registre General d'entrada i sortida de documents. Estudi d’un cas: El Registre General de l'Ajuntament de Santa Perpètua de Mogoda

El treball de recerca del Màster en Arxivística i Gestió de Documents de l’ESAGED (Escola Superior d’Arxivística i Gestió de Documents) ha consistit en l’estudi i l’avaluació del registre general d’entrades i sortides de documents de l’Ajuntament de Santa Perpètua de Mogoda, en fase de producció. A més d’estudiar-ne el context extern i intern s’han auditat les funcionalitats de l’eina tecnològica que gestiona el Registre General. S’explica el desenvolupament de la recerca i els resultats obtinguts. Finalment, es presenten les propostes de millora en fase de producció a fi d’augmentar l’autenticitat i la integritats de les dades, i també unes propostes de conservació del Registre General actual. Paraules clau: Registre General, preservació, base de dades, assentaments, ajuntament, classificació, gestió de documents, dades, informació, fiabilitat, integritat, autenticitat.

Modelos de demanda por manzanas frescas chilenas en países de la Unión Europea

Se usó la técnica de regresión de mínimos cuadrados ordinarios para estimar la demanda por importaciones de manzanas frescas exportadas por Chile en cinco países de la Unión Europea. Para las estimaciones se utilizaron observaciones anuales del periodo 1984 a 2003. Los resultados demuestran que (1) la demanda por importaciones de manzanas frescas chilenas depende de las tradicionales variables ingreso o gasto en consumo per cápita, (2) los precios relativos y la variación del tipo de cambio real juegan un papel destacado en la explicación de la demanda por importaciones, y (3) la demanda responde de manera diferente frente a los cambios en las variables explicativas en cada mercado.

Chemical, physico-chemical and sensory characterization of mixed açai (Euterpe oleracea) and cocoa´s honey (Theobroma cacao) jellies

Four formulations of mixed açaí (Euterpe oleracea) (A) and cocoa´s honey (Theobroma cacao) (CH) jellies were prepared according to the following proportions: T1 (40% A:60% CH), T2 (50% A:50% CH), T3 (60% A: 40% CH) and T4 (100% A - control). All formulations were prepared using a rate 60:40 (w/w) of sucrose and pulp, plus 0.5% pectin and the products reached to average of 65% soluble solids content. The jellies were analyzed by chemical and physicochemical (titratable acidity, pH, soluble solid content, dry matter, total protein, lipids, vitamin C and calories) and sensory characteristics; also were evaluated levels of P, K, Ca, Mg, Fe, Zn, Cu and Mn. It was used a hedonic scale of 7 points to evaluate the attributes: overall impression, spreadability, brightness, flavor, texture and color, and also was verified the purchase intention score. The titratable acidity and pH ranged from 0.46 to 0.64% and 3.35 to 3.64, respectively, that are within the range found at most fruit jellies. The soluble solids content ranged between 65.2 and 65.5 ºBrix. The sensory acceptance results showed that all treatments (T1, T2, T3 and T4) presented means of sensory attributes above 4, demonstrating good acceptance of the product, but the treatment T1 presented the higher scores for the evaluated attributes. Cocoa´s honey added a positive influence on the attributes of color, texture and spreadability.

Distribución espacial de la población inmigrante en los municipios catalanes: igualdad, exposición, concentración y centralidad

Dado el importante crecimiento de la población inmigrante en España, es interesante estudiar su distribución sobre el territorio urbano. Desde la estadística se dispone de diferentes indicadores con una larga tradición, que permiten cuantificar la segregación de grupos de población minoritarios. Mediante la aplicación de estas herramientas a la realidad de los municipios catalanes, se muestra su utilidad a la hora de analizar la segregación residencial dentro de una ciudad, y detectar las pautas que rigen este fenómeno. Los resultados muestran que no hay relación clara entre el porcentaje de población extranjera y el nivel de segregación, y que la segregación difiere según el grupo observado. Una nueva perspectiva de la segregación se obtiene con la utilización de indicadores diseñados mediante elementos de estadística espacial. La combinación de todas estas medidas representa un procedimiento útil para el análisis de la distribución de la población inmigrante en las zonas urbanas, su utilidad se extiende a diferentes áreas como la sociología, la economía, el urbanismo o las políticas de vivienda.

Clinical determinants of early parasitological response to ACTs in African patients with uncomplicated falciparum malaria: a literature review and meta-analysis of individual patient data.

BACKGROUND: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treated with artemisinin-based combination therapies (ACTs). METHODS: A literature review in PubMed was conducted in March 2013 to identify all prospective clinical trials (uncontrolled trials, controlled trials and randomized controlled trials), including ACTs conducted in Sub-Saharan Africa, between 1960 and 2012. Individual patient data from these studies were shared with the WorldWide Antimalarial Resistance Network (WWARN) and pooled using an a priori statistical analytical plan. Factors affecting early parasitological response were investigated using logistic regression with study sites fitted as a random effect. The risk of bias in included studies was evaluated based on study design, methodology and missing data. RESULTS: In total, 29,493 patients from 84 clinical trials were included in the analysis, treated with artemether-lumefantrine (n = 13,664), artesunate-amodiaquine (n = 11,337) and dihydroartemisinin-piperaquine (n = 4,492). The overall parasite clearance rate was rapid. The parasite positivity rate (PPR) decreased from 59.7 % (95 % CI: 54.5-64.9) on day 1 to 6.7 % (95 % CI: 4.8-8.7) on day 2 and 0.9 % (95 % CI: 0.5-1.2) on day 3. The 95th percentile of observed day 3 PPR was 5.3 %. Independent risk factors predictive of day 3 positivity were: high baseline parasitaemia (adjusted odds ratio (AOR) = 1.16 (95 % CI: 1.08-1.25); per 2-fold increase in parasite density, P <0.001); fever (>37.5 °C) (AOR = 1.50 (95 % CI: 1.06-2.13), P = 0.022); severe anaemia (AOR = 2.04 (95 % CI: 1.21-3.44), P = 0.008); areas of low/moderate transmission setting (AOR = 2.71 (95 % CI: 1.38-5.36), P = 0.004); and treatment with the loose formulation of artesunate-amodiaquine (AOR = 2.27 (95 % CI: 1.14-4.51), P = 0.020, compared to dihydroartemisinin-piperaquine). CONCLUSIONS: The three ACTs assessed in this analysis continue to achieve rapid early parasitological clearance across the sites assessed in Sub-Saharan Africa. A threshold of 5 % day 3 parasite positivity from a minimum sample size of 50 patients provides a more sensitive benchmark in Sub-Saharan Africa compared to the current recommended threshold of 10 % to trigger further investigation of artemisinin susceptibility.

El sonido de la guerra: Las trompas de la Fortaleza Medieval de Ausa (Zaldibia, Guipuzcoa)

During the fieldwork in the medieval fortification of Ausa (Gipuzkoa), a vast amount of sherds from several pottery artifacts featured by a cylindrical body has been found out. They presumably had the same function in contexts dated from the first half of xiv century. Although it has not been possible to reconstruct any of these artefacts, the study of the sherds allows us to think that they would have formed some sort of big-sized horn. This high-sounding instrument, which has been frequently reproduced in iconographic references, does not have at this moment any direct parallelism in Hispanic contexts, despite being plentiful of references to similar objects in medieval ranges from Provence and Languedoc. By introducing these artefacts from different approaches, we aim to go over the scarce knowledge of these instruments, whose evidence lets us to believe in their widespread distribution all over the landscape in several material contexts from Medieval Ages.

El sonido de la guerra: Las trompas de la Fortaleza Medieval de Ausa (Zaldibia, Guipuzcoa)

During the fieldwork in the medieval fortification of Ausa (Gipuzkoa), a vast amount of sherds from several pottery artifacts featured by a cylindrical body has been found out. They presumably had the same function in contexts dated from the first half of xiv century. Although it has not been possible to reconstruct any of these artefacts, the study of the sherds allows us to think that they would have formed some sort of big-sized horn. This high-sounding instrument, which has been frequently reproduced in iconographic references, does not have at this moment any direct parallelism in Hispanic contexts, despite being plentiful of references to similar objects in medieval ranges from Provence and Languedoc. By introducing these artefacts from different approaches, we aim to go over the scarce knowledge of these instruments, whose evidence lets us to believe in their widespread distribution all over the landscape in several material contexts from Medieval Ages.

Achados ultra-sonográficos abdominais em pacientes com dengue

OBJETIVO: Apresentar os achados ultra-sonográficos abdominais em pacientes com dengue e compará-los aos descritos na literatura. MATERIAIS E MÉTODOS: Foram realizados exames ultra-sonográficos abdominais de 38 pacientes, 25 do sexo feminino e 13 do sexo masculino, com idade média de 35 anos, com diagnóstico de dengue sorologicamente confirmado. Os achados foram comparados com os descritos na literatura. RESULTADOS: Os achados ultra-sonográficos mais relevantes foram espessamento difuso da parede da vesícula biliar em 18 casos (47,4%), líquido livre na cavidade abdominal e/ou pélvica em 12 (31,6%), esplenomegalia em 11 (28,9%), hepatomegalia em 10 (26,3%) e líquido pericolecístico em 10 (26,3%). Vinte e seis por cento dos pacientes apresentaram exames ultra-sonográficos normais. CONCLUSÃO: Os achados ultra-sonográficos abdominais são uma ferramenta adicional útil na confirmação de casos suspeitos de dengue hemorrágica e na detecção precoce da gravidade e da progressão da doença, sendo de extrema importância para o radiologista o conhecimento destes possíveis achados.

Le rationnement implicite en Suisse : aperçu de la situation en psychiatrie

L'objectif de ce travail est de chercher à savoir si la question du rationnement, plus particulièrement implicite, se pose dans le domaine de la psychiatrie. Comment ce phénomène est-il appréhendé et quelles formes peut-il prendre dans les faits? Nous avons souhaité établir quels facteurs pouvaient constituer les indicateurs les plus pertinents pour mettre en évidence un rationnement implicite dans le contexte suisse actuel. Méthode: Notre premier instrument de recherche a été une série d'entretiens semi-structurés avec principalement des médecins psychiatres et accessoirement des représentants d'associations de patients et de leurs proches.* Nous avons rencontré des psychiatres généralistes et spécialistes (n= 12 + 2 contacts téléphoniques), travaillant en institution et/ou installés en privé ainsi que des informateurs exprimant les perspectives des patients et de leur entourage (n=2 + 2 contacts téléphoniques). L'analyse intermédiaire des entretiens a permis d'identifier les clés de compréhension des enjeux principaux entrant dans l'identification de processus de rationnement et guider la recherche de données factuelles pertinentes. Notre deuxième source d'information a constitué en rapports de commission, bulletins d'activité ainsi que d'articles de la presse nationale hebdomadaire et quotidienne consultés via internet selon les mots-clé de « rationnement » et de « psychiatrie ».

Ameloblastoma da mandíbula: relato de dois casos

Ameloblastomas são neoplasias odontogênicas benignas de origem epitelial, não mineralizadas, relativamente incomuns e que apresentam um comportamento localmente agressivo. Acometem predominantemente a mandíbula e podem atingir proporções variadas, de acordo com o tempo de evolução. Radiologicamente, comportam-se como lesões císticas uniloculadas ou multiloculadas. Os achados clínicos e radiológicos auxiliam no diagnóstico diferencial, embora a avaliação histológica seja necessária para a caracterização das lesões.